Harrell’s Car Wash Systems is committed to providing equal employment opportunity to all employees and applicants for employment. Equal access to employment is available to all qualified persons. Applicants requiring an accommodation to the application and/or interview process should notify the Human Resources Department. You are not required to furnish any information on this application that is prohibited by federal, state, or local law.

Application for Employment

All fields are required - If not applicable, put "N/A" or "NONE"

Position Applying For

Date of Application

Referral Source

First Name

Middle Name

Last Name

Social Security #

Street Address

City

State

Zip

Date of Birth

Home Phone #

Cell Phone #

E-mail Address

Are you legally eligible for employment in this country?YesNo Proof of U.S. citizenship or immigration status will be required upon employment.

Date you are available for work

Type of employment desiredFull TimePart TimeTemporarySeasonal

Are you on lay off and subject to recall?YesNo

Are you willing to relocate?YesNo

Are you willing to travel?YesNo

Will you work overtime if required?YesNo

Drivers License Number

State

Employment History

List your last four employers, assignments or volunteer activities starting with the most recent, including military experience. Explain any gaps.

Employer 1

Employer Name

Employer Phone #

Street Address

City

State

Zip

Dates Employed - From

To

Your Job Title

Immediate Supervisor

Reason for leaving

May we contact a reference?YesNo

Summarize the nature of the work performed and job responsibilities:

Employer 2

Employer Name

Employer Phone #

Street Address

City

State

Zip

Dates Employed - From

To

Your Job Title

Immediate Supervisor

Reason for leaving

May we contact a reference?YesNo

Summarize the nature of the work performed and job responsibilities:

Employer 3

Employer Name

Employer Phone #

Street Address

City

State

Zip

Dates Employed - From

To

Your Job Title

Immediate Supervisor

Reason for leaving

May we contact a reference?YesNo

Summarize the nature of the work performed and job responsibilities:

Employer 4

Employer Name

Employer Phone #

Street Address

City

State

Zip

Dates Employed - From

To

Your Job Title

Immediate Supervisor

Reason for leaving

May we contact a reference?YesNo

Summarize the nature of the work performed and job responsibilities:

Educational Background

School

Number of Years Completed

Degree or Diploma

School

Number of Years Completed

Degree or Diploma

School

Number of Years Completed

Degree or Diploma

Skills and Qualifications

Awards, Publications, Professional, Trade, Business or Civic Associations, and any offices held (Excluding information which would reveal sex, race, religion, national origin, age, color, disability, or other protected status.)

List any additional information you would like us to consider.

References

Name

Phone

Years Known

Name

Phone

Years Known

Name

Phone

Years Known

Addresses for the Past 5 Years

Street Address

City

State

Zip

From

To

Street Address

City

State

Zip

From

To

Acknowledgment

I understand and agree that any misrepresentation or omission by me in this application will result in the cancellation of this application and/or termination of my employment if I am hired by Harrell’s Car Wash Systems, Inc. ("Harrell’s Car Wash" or the "Company"). Furthermore, I understand that, if I am offered employment with Harrell’s Car Wash, any such employment will be "at-will" which means that just as I am free to resign at any time, Harrell’s Car Wash reserves the right to terminate my employment at any time, with or without cause and without prior notice.

I authorize Harrell’s Car Wash to investigate all references and other information provided in the above employment application. I hereby release from liability Harrell’s Car Wash and its representatives for seeking such information and all other persons or corporations for furnishing such information.

If I am employed, I authorize Harrell's Car Wash to investigate my driving record at any time during my employment. If I am deemed uninsurable by Harrell's Car Wash's auto insurance company for any reason, I understand that I will be subject to discharge.

I understand that Harrell’s Car Wash is an Equal Opportunity Employer that does not discriminate in employment, and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state, or federal law.

I also understand that if I am offered employment with Harrell’s Car Wash, any such offer will be conditioned upon satisfactory results of a drug and/or alcohol test. I agree to submit to a drug and/or alcohol test as a condition of my employment and at any time during the course of my employment.

This application is valid for only 60 days. At the conclusion of this time, if I have not heard from Harrell's Car Wash and still wish to be considered for employment, it will be necessary for me to fill out a new application.

Release of Liability

I hereby forever release and discharge Harrell's Car Wash and its officers, directors, shareholders, agents and employees, as well as successors, assignees and all other persons acting on its behalf, from any claims, liability, action for damages, compensation or otherwise, known or unknown, on account of or arising out of the investigation and disclosure of the information requested in this Application for Employment.

I further release and discharge all liability from all companies, agencies, officials, employees and persons providing good faith, pertinent information and/or records as requested to successfully complete a background investigation for my application of employment.

I understand and agree that under current law, an online acknowledgment or electronic signature generally has the same effect and the same force as a written signature. By submitting this electronic Application for Employment, I acknowledge my electronic signature of this Application, and affirm the truth and accuracy of the information provided by me.